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The Effect of AyuFlex® Supplementation on Joint Health

Primary Purpose

Arthralgia

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
AyuFlex
Placebo
Sponsored by
The Center for Applied Health Sciences, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Arthralgia

Eligibility Criteria

35 Years - 70 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Healthy male or female volunteers >35 to <70 years of age.
  • Non-smoker.
  • Body Mass Index (BMI) greater than 30 kg/m2 and less than 45 kg/m2 at screening.
  • Willing to maintain current background dietary and physical activity pattern throughout study period.
  • Knee joint:

    • No knee joint discomfort at rest.
    • Experience knee joint discomfort with activity or exercise within the last 2 weeks of at least 30 mm out of 100mm on VAS rating for "knee discomfort with activity or exercise at any time over the last 3 weeks".
    • Must achieve a rating of at least 30mm on a 100mm VAS at any point throughout the standardized lower extremity exercise performance screening test (Screening test = 3 sets of 10-12 repetitions on seated knee extension machine + 3-minute walk test at maximal walking velocity).
  • Non-pregnant, non-lactating females who agree to use effective contraceptive methods throughout the course of the study.
  • Females of childbearing potential must agree to use one of the following acceptable birth control methods:

    1. Surgically sterile (hysterectomy or bilateral oophorectomy);
    2. Surgically sterile (bilateral tubal ligation with surgery at least 6 weeks prior to study initiation);
    3. Intrauterine device (IUD) in place for at least 3 months;
    4. Abstinence (not having sexual intercourse);
    5. Barrier method (condom or diaphragm) with spermicide for at least 14 days prior to screening and through study completion;
    6. Vasectomized partner.
  • Able to understand study procedures and provide signed informed consent, and authorizes release of relevant health information to study investigator.
  • Normally active and otherwise judged to be in good health on the basis of medical history and physical examination.
  • Females of childbearing potential must have a negative urine pregnancy test at screening.

Exclusion Criteria:

  • Subjects with an established diagnosis of inflammatory joint disorder or osteoarthritis per ACR (American College of Rheumatology) guidelines.
  • Currently taking, or chronic use within 30 days of anti-inflammatory supplements, Boswellia, Curcumin, Omega-3 fatty acids, Glucosamine, Chondroitin, MSM, or Collagen supplements of any type.
  • Daily use of NSAIDs (non-steroidal anti-inflammatory drugs); however, daily use of 81 mg of aspirin (not > 81 mg) for cardioprotection is allowed.
  • Upon physical screening by the medical staff, any subject with signs of overt nutrient deficiencies or metabolic abnormalities such as anemia. This will also need to be included in the screening assessment.
  • Subjects with a history of knee or hip joint replacement surgery, or any hip or back pain which interferes with walking or exercise testing utilized throughout the study.
  • Glucocorticoid (Corticosteroid) injection, hyaluronic acid injection, prolotherapy, or PRP (platelet rich plasma) injection, bone marrow or other regenerative injection in affected knee within 6 months prior to enrollment in study.
  • Individual has any recent illness or condition (within 6 months of screening) that the Investigator believes would interfere with his or her ability to provide informed consent, comply with the study protocol, or might confound the interpretation of the study results or put the person at undue risk.
  • Known or suspected pregnancy, planned pregnancy, or lactation.
  • If the subjects has been treated for any psychiatric illness or hospitalized for such within the past year, upon PI discretion, will be excluded from the study.
  • History of allergic reaction or known sensitivity to Terminalia chebula or other chemically related botanical/ herbal products or supplements.
  • Any food allergy, intolerance, restriction or special diet that, in the opinion of the Investigator, could contraindicate the subject's participation in this study.
  • Vital sign abnormalities (seated, resting systolic blood pressure lower than 90 or higher than 150 mmHg, diastolic blood pressure lower than 50 or higher than 100 mmHg, or heart rate less than 50 or more than 110 bpm) at screening.
  • History or clinically significant gastrointestinal disorder, (eg, inflammatory bowel diseases), presence of any gastrointestinal pathology, persistent gastrointestinal symptoms (eg, diarrhea, vomiting), liver or kidney disease, gastric bypass, gastric stapling, use of Lapband, or other conditions known to interfere with the absorption, distribution, metabolism, or excretion of dietary supplements.
  • History of active neurological, endocrine, cardiovascular, pulmonary, hematological, immunologic/ autoimmune, psychiatric, or metabolic disease that is considered clinically significant by the PI.
  • Recent history of (within past 12 months), or strong potential for, alcohol or substance abuse. Alcohol abuse will be defined as >14 drinks per week (1 drink = 12 oz beer, 5.0 oz wine, or 1.5 oz distilled spirits).
  • Exposure to any investigational agent or drug product within 30 days prior to study entry.
  • Subjects who have any physical disability which could interfere with their ability to perform the functional performance measures included in this protocol.
  • Individual has a condition the Investigator believes would interfere with the ability to provide informed consent or comply with study instructions, or that might confound the interpretation of the study results or put the patient at undue risk.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Placebo Comparator

    Active Comparator

    Active Comparator

    Arm Label

    Placebo

    AyuFlex1

    AyuFlex2

    Arm Description

    placebo

    AyuFlex1 (500 mg/d)

    AyuFlex2 (1000 mg/d)

    Outcomes

    Primary Outcome Measures

    Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
    Visual Analogue Scale scores for discomfort, mobility, disability

    Secondary Outcome Measures

    Inflammatory biomarkers
    tumor necrosis factor-alpha, c-reactive protein, and cartilage oligomeric matrix protein
    6 minute walk test
    Total distance covered in 6 minutes
    Range of motion of pain-free knee flexion/extension
    Blood chemistry
    Comprehensive metabolic panel, CBC, lipid panel
    Vital signs
    Resting heart rate and blood pressure

    Full Information

    First Posted
    October 26, 2015
    Last Updated
    April 16, 2017
    Sponsor
    The Center for Applied Health Sciences, LLC
    Collaborators
    Natreon, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02589249
    Brief Title
    The Effect of AyuFlex® Supplementation on Joint Health
    Official Title
    The Effect of AyuFlex® Dietary Supplementation on Joint Mobility, Comfort and Functional Capacity in Healthy Overweight Subjects
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2017
    Overall Recruitment Status
    Completed
    Study Start Date
    November 2015 (undefined)
    Primary Completion Date
    February 7, 2017 (Actual)
    Study Completion Date
    February 7, 2017 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    The Center for Applied Health Sciences, LLC
    Collaborators
    Natreon, Inc.

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The purpose of this 12-week, prospective study is to determine the effects of oral supplementation with AyuFlex® (an over-the-counter dietary supplement) on joint mobility, joint comfort and functional capacity in healthy overweight subjects.
    Detailed Description
    This interventional study is a 12-week, randomized, double-blind, placebo and dose-response controlled clinical trial (in 3 parallel groups) of male and female subjects without active osteoarthritis of the knee to be recruited at a single investigational center in the U.S. A two-week placebo lead-in period will precede the study to enhance statistical power. One-hundred and five (105) overweight, apparently healthy subjects, pre-screened using health history questionnaires, vital signs, blood work and a standardized lower extremity exercise performance test will be randomized to one of three groups for 84 days: placebo, AyuFlex1 (500 mg/d) or AyuFlex2 (1000 mg/d). AyuFlex is an organic, non-GMO, over-the-counter joint health product derived from the edible fruits of Terminalia chebula.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Arthralgia

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    105 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    placebo
    Arm Title
    AyuFlex1
    Arm Type
    Active Comparator
    Arm Description
    AyuFlex1 (500 mg/d)
    Arm Title
    AyuFlex2
    Arm Type
    Active Comparator
    Arm Description
    AyuFlex2 (1000 mg/d)
    Intervention Type
    Dietary Supplement
    Intervention Name(s)
    AyuFlex
    Intervention Description
    Active product
    Intervention Type
    Dietary Supplement
    Intervention Name(s)
    Placebo
    Intervention Description
    Placebo
    Primary Outcome Measure Information:
    Title
    Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
    Time Frame
    Change in score from Day 0 to day 14, 42, and 84
    Title
    Visual Analogue Scale scores for discomfort, mobility, disability
    Time Frame
    Change in score from Day 0 to day 14, 42, and 84
    Secondary Outcome Measure Information:
    Title
    Inflammatory biomarkers
    Description
    tumor necrosis factor-alpha, c-reactive protein, and cartilage oligomeric matrix protein
    Time Frame
    Change from Day 0 to 84
    Title
    6 minute walk test
    Description
    Total distance covered in 6 minutes
    Time Frame
    Change in score from Day 0 to day 14, 42, and 84
    Title
    Range of motion of pain-free knee flexion/extension
    Time Frame
    Change from Day 0 to 84
    Title
    Blood chemistry
    Description
    Comprehensive metabolic panel, CBC, lipid panel
    Time Frame
    Change from Day 0 to 84
    Title
    Vital signs
    Description
    Resting heart rate and blood pressure
    Time Frame
    Change in score from Day 0 to day 14, 42, and 84

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    35 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Healthy male or female volunteers >35 to <70 years of age. Non-smoker. Body Mass Index (BMI) greater than 30 kg/m2 and less than 45 kg/m2 at screening. Willing to maintain current background dietary and physical activity pattern throughout study period. Knee joint: No knee joint discomfort at rest. Experience knee joint discomfort with activity or exercise within the last 2 weeks of at least 30 mm out of 100mm on VAS rating for "knee discomfort with activity or exercise at any time over the last 3 weeks". Must achieve a rating of at least 30mm on a 100mm VAS at any point throughout the standardized lower extremity exercise performance screening test (Screening test = 3 sets of 10-12 repetitions on seated knee extension machine + 3-minute walk test at maximal walking velocity). Non-pregnant, non-lactating females who agree to use effective contraceptive methods throughout the course of the study. Females of childbearing potential must agree to use one of the following acceptable birth control methods: Surgically sterile (hysterectomy or bilateral oophorectomy); Surgically sterile (bilateral tubal ligation with surgery at least 6 weeks prior to study initiation); Intrauterine device (IUD) in place for at least 3 months; Abstinence (not having sexual intercourse); Barrier method (condom or diaphragm) with spermicide for at least 14 days prior to screening and through study completion; Vasectomized partner. Able to understand study procedures and provide signed informed consent, and authorizes release of relevant health information to study investigator. Normally active and otherwise judged to be in good health on the basis of medical history and physical examination. Females of childbearing potential must have a negative urine pregnancy test at screening. Exclusion Criteria: Subjects with an established diagnosis of inflammatory joint disorder or osteoarthritis per ACR (American College of Rheumatology) guidelines. Currently taking, or chronic use within 30 days of anti-inflammatory supplements, Boswellia, Curcumin, Omega-3 fatty acids, Glucosamine, Chondroitin, MSM, or Collagen supplements of any type. Daily use of NSAIDs (non-steroidal anti-inflammatory drugs); however, daily use of 81 mg of aspirin (not > 81 mg) for cardioprotection is allowed. Upon physical screening by the medical staff, any subject with signs of overt nutrient deficiencies or metabolic abnormalities such as anemia. This will also need to be included in the screening assessment. Subjects with a history of knee or hip joint replacement surgery, or any hip or back pain which interferes with walking or exercise testing utilized throughout the study. Glucocorticoid (Corticosteroid) injection, hyaluronic acid injection, prolotherapy, or PRP (platelet rich plasma) injection, bone marrow or other regenerative injection in affected knee within 6 months prior to enrollment in study. Individual has any recent illness or condition (within 6 months of screening) that the Investigator believes would interfere with his or her ability to provide informed consent, comply with the study protocol, or might confound the interpretation of the study results or put the person at undue risk. Known or suspected pregnancy, planned pregnancy, or lactation. If the subjects has been treated for any psychiatric illness or hospitalized for such within the past year, upon PI discretion, will be excluded from the study. History of allergic reaction or known sensitivity to Terminalia chebula or other chemically related botanical/ herbal products or supplements. Any food allergy, intolerance, restriction or special diet that, in the opinion of the Investigator, could contraindicate the subject's participation in this study. Vital sign abnormalities (seated, resting systolic blood pressure lower than 90 or higher than 150 mmHg, diastolic blood pressure lower than 50 or higher than 100 mmHg, or heart rate less than 50 or more than 110 bpm) at screening. History or clinically significant gastrointestinal disorder, (eg, inflammatory bowel diseases), presence of any gastrointestinal pathology, persistent gastrointestinal symptoms (eg, diarrhea, vomiting), liver or kidney disease, gastric bypass, gastric stapling, use of Lapband, or other conditions known to interfere with the absorption, distribution, metabolism, or excretion of dietary supplements. History of active neurological, endocrine, cardiovascular, pulmonary, hematological, immunologic/ autoimmune, psychiatric, or metabolic disease that is considered clinically significant by the PI. Recent history of (within past 12 months), or strong potential for, alcohol or substance abuse. Alcohol abuse will be defined as >14 drinks per week (1 drink = 12 oz beer, 5.0 oz wine, or 1.5 oz distilled spirits). Exposure to any investigational agent or drug product within 30 days prior to study entry. Subjects who have any physical disability which could interfere with their ability to perform the functional performance measures included in this protocol. Individual has a condition the Investigator believes would interfere with the ability to provide informed consent or comply with study instructions, or that might confound the interpretation of the study results or put the patient at undue risk.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Tim N Ziegenfuss, PhD
    Organizational Affiliation
    The Center for Applied Health Sciences
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided
    Citations:
    PubMed Identifier
    28969626
    Citation
    Lopez HL, Habowski SM, Sandrock JE, Raub B, Kedia A, Bruno EJ, Ziegenfuss TN. Effects of dietary supplementation with a standardized aqueous extract of Terminalia chebula fruit (AyuFlex(R)) on joint mobility, comfort, and functional capacity in healthy overweight subjects: a randomized placebo-controlled clinical trial. BMC Complement Altern Med. 2017 Oct 2;17(1):475. doi: 10.1186/s12906-017-1977-8.
    Results Reference
    derived

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    The Effect of AyuFlex® Supplementation on Joint Health

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